When a patient seeks healthcare services from a healthcare provider, various processes may be performed between the time when patient data is received and when healthcare services are provided. The various processes may make up a patient access workflow and may include such processes as, but are not limited to, verifying coverages (e.g., insurance eligibility and verification), verifying demographic data to help ensure that a patient's demographic data is correct for insurance claims, billing statements, etc., checking payer compliance to help screen for payer medical necessity and precertification and to aid with accuracy in orders, coding and billing, estimating a payment amount, determining a patient's financial situation to help mitigate the risk of late payments and possible need for collections later on, and collecting payment for services.
One or more users, such as administrative users, may utilize one or more tools for patient account clearance (performing the patient access workflow). A user may be provided with a plurality of patient accounts needing to be cleared prior to the patients arriving for a healthcare encounter. The user may clear accounts in an order in which the accounts are provided to him, or may analyze various accounts to determine which one may be deemed a higher priority to clear next. As can be appreciated, a first-in-first-out approach may oftentimes not be effective. For example, if an account is received that may take longer to process because of various factors, but has a short lead time before the patient arrives for a healthcare encounter, the patient access workflow process may not be completed prior to when the patient arrives for healthcare services. Additionally, relying on a user to determine which account may be a higher priority account to clear next may be unreliable and inaccurate.
It is with respect to these and other considerations that the present invention has been made.